Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA.
Department of Nutrition and Food Science, University of Ghana, Ghana.
J Nutr. 2019 May 1;149(5):847-855. doi: 10.1093/jn/nxz005.
Few studies have evaluated the long-term effects of nutritional supplementation during the first 1000 d of life. We previously reported that maternal and child lipid-based nutrient supplements (LNS) increased child length by 18 mo.
The aim of this study was to examine the effects of LNS on later growth and body composition at 4-6 y of age.
This was a follow-up of children in the International Lipid-based Nutrient Supplements (iLiNS)-DYAD trial in Ghana. Women (n = 1320) at ≤20 weeks of gestation were randomly assigned to: 1) iron and folic acid during pregnancy and 200 mg calcium/d for 6 mo postpartum, 2) multiple micronutrients (1-2 RDA of 18 vitamins and minerals) during both periods, or 3) maternal LNS during both periods plus child LNS from 6 to 18 mo. At 4-6 y, we compared height, height-for-age z score (HAZ), and % body fat (deuterium dilution method) between the LNS group and the 2 non-LNS groups combined.
Data were available for 961 children (76.5% of live births). There were no significant differences between LNS compared with non-LNS groups in height [106.7 compared with 106.3 cm (mean difference, MD, 0.36; P = 0.226)], HAZ [-0.49 compared with -0.57 (MD = 0.08; P = 0.226)], stunting (< -2 SD) [6.5 compared with 6.3% (OR = 1.00; P = 0.993)], or % body fat [15.5 compared with 15.3% (MD = 0.16; P = 0.630)]. However, there was an interaction with maternal prepregnancy BMI (kg/m2) (P-interaction = 0.046 before correction for multiple testing): among children of women with BMI < 25 , LNS children were taller than non-LNS children (+1.1 cm, P = 0.017), whereas there was no difference among children of women with BMI ≥ 25 (+0.1 cm; P = 0.874).
There was no overall effect of LNS on height at 4-6 y in this cohort, which had a low stunting rate, but height was greater in the LNS group among children of nonoverweight/obese women. There was no adverse impact of LNS on body composition. This trial was registered at clinicaltrials.gov as NCT00970866.
很少有研究评估生命最初 1000 天内营养补充的长期影响。我们之前报告称，孕产妇和儿童脂质营养素补充剂（LNS）可使儿童在 18 个月时增加 18 厘米的身高。
本研究旨在探讨 LNS 对 4-6 岁时生长和身体成分的影响。
这是加纳国际脂类营养素补充剂（iLiNS）-DYAD 试验中儿童的随访。在妊娠≤20 周的女性（n=1320）中，随机分配至：1）孕期补充铁和叶酸，产后 6 个月补充 200mg 钙；2）孕期和产后均补充多种微量营养素（1-2 份 RDA 共 18 种维生素和矿物质）；3）孕期和产后均补充 LNS 并在 6-18 个月时补充儿童 LNS。在 4-6 岁时，我们比较了 LNS 组和 2 个非 LNS 组的身高、身高年龄 z 评分（HAZ）和体脂肪百分比（氘稀释法）。
961 名儿童（活产儿的 76.5%）的数据可用。与非 LNS 组相比，LNS 组在身高[106.7cm 比 106.3cm（平均差异，MD，0.36；P=0.226）]、HAZ[-0.49 比 -0.57（MD=0.08；P=0.226）]、生长迟缓（< -2 SD）[6.5%比 6.3%（比值比，OR，1.00；P=0.993）]或体脂肪百分比[15.5%比 15.3%（MD=0.16；P=0.630）]方面无显著差异。然而，与母亲妊娠前 BMI（kg/m2）存在交互作用（多重检验校正前 P 交互值=0.046）：在 BMI<25kg/m2 的女性的儿童中，LNS 儿童比非 LNS 儿童高 1.1cm（P=0.017），而 BMI≥25kg/m2 的女性的儿童之间无差异（高 0.1cm；P=0.874）。
在本队列中，LNS 对 4-6 岁时的身高没有总体影响，该队列的生长迟缓率较低，但在非超重/肥胖女性的儿童中，LNS 组的身高更高。LNS 对身体成分没有不良影响。本试验在 clinicaltrials.gov 注册，编号为 NCT00970866。
